WO2010113960A1 - Agent pour inhiber l'épaississement de la membrane péritonéale - Google Patents

Agent pour inhiber l'épaississement de la membrane péritonéale Download PDF

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WO2010113960A1
WO2010113960A1 PCT/JP2010/055728 JP2010055728W WO2010113960A1 WO 2010113960 A1 WO2010113960 A1 WO 2010113960A1 JP 2010055728 W JP2010055728 W JP 2010055728W WO 2010113960 A1 WO2010113960 A1 WO 2010113960A1
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group
tetramethylchroman
peritoneal
thickening
residue
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PCT/JP2010/055728
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English (en)
Japanese (ja)
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博宣 村瀬
雅司 友
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シーシーアイ株式会社
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Priority to JP2011507223A priority Critical patent/JP5652963B2/ja
Priority to CN201080019637.5A priority patent/CN102596982B/zh
Priority to US13/259,558 priority patent/US8841262B2/en
Priority to EP10758731.3A priority patent/EP2415775B1/fr
Publication of WO2010113960A1 publication Critical patent/WO2010113960A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7048—Compounds having saccharide radicals and heterocyclic rings having oxygen as a ring hetero atom, e.g. leucoglucosan, hesperidin, erythromycin, nystatin, digitoxin or digoxin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/287—Dialysates therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
    • A61P7/08—Plasma substitutes; Perfusion solutions; Dialytics or haemodialytics; Drugs for electrolytic or acid-base disorders, e.g. hypovolemic shock
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
    • C07H15/00—Compounds containing hydrocarbon or substituted hydrocarbon radicals directly attached to hetero atoms of saccharide radicals
    • C07H15/26—Acyclic or carbocyclic radicals, substituted by hetero rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation

Definitions

  • the present invention relates to a peritoneal thickening inhibitor that suppresses thickening of the peritoneum.
  • peritoneal dialysis is performed by storing a dialysis solution with high osmotic pressure through the catheter inside the abdominal cavity surrounded by the peritoneum that covers the internal organs such as the stomach and intestine, by previously embedding a catheter in the abdomen.
  • This is based on the fact that osmotic pressure difference occurs between the fluid and body fluid, and excess water and waste in the living body move from peritoneal capillaries to peritoneal dialysis fluid in the abdominal cavity. Therefore, the treatment by peritoneal dialysis does not require a device for drawing blood out of the body as compared with hemodialysis, so the burden on the patient is low from the viewpoint of “quality of life”.
  • EPS sclerosing encapsulating peritonitis
  • peritoneal sclerosis peritoneal fibrosis.
  • EPS sclerosing encapsulating peritonitis
  • peritoneal sclerosis peritoneal fibrosis.
  • the cause of peritoneal thickening has not been elucidated.
  • Non-Patent Document 1 for example, an abnormal blood vessel or an increase in the number of blood vessels is observed in the thickened peritoneal tissue, or the intraperitoneal cavity of a patient undergoing peritoneal dialysis.
  • VEGF vascular endothelial growth factor
  • Non-Patent Document 2 the expression of a molecular chaperone Hsp47 specific to collagen is a cause of peritoneal thickening, and Hsp47 is expressed in mesothelial cells and actin-positive cells to produce type I and type III collagen. It has been reported. Furthermore, there exists patent document 1 as invention which suppresses the peritoneal thickening relevant to this report, for example. Patent Document 1 describes that after intraperitoneal thickening of a rat with chlorhexidine gluconate in the abdominal cavity of a rat in advance, an oligonucleotide was administered intraperitoneally as a substance that inhibits Hsp47.
  • Patent Document 2 As a technique focusing on the relationship between the abnormal production of collagen and angiogenesis, there is an invention for suppressing the production of collagen shown in Patent Document 2, for example.
  • the invention of Patent Document 2 is that peritoneal thickening is achieved by administering a drug that inhibits vascular endothelial growth factor (VEGF) as angiogenesis is involved in peritoneal thickening disease.
  • VEGF vascular endothelial growth factor
  • collagen synthesis in the extracellular skeleton such as the basement membrane plays an important role in angiogenesis (Maragodakis, E., Sarmonika, M., and Panoutosacoporous, M., J. Pharmacol. Exp.
  • Non-Patent Document 3 reports that the peritoneal injury of chlorhexidine is alleviated by the administration of ganciclovir, an antiviral agent, and after chlorhexidine was administered intraperitoneally to the peritoneum of a mouse in advance, 2 It is described that peritoneal thickening is reduced when ganciclovir is injected intraperitoneally after a week.
  • JP 2001-31588 A JP-A-8-301784 TNP-470 an angiogenesis inhibitor, suppression the progression of peripheral fibrosis in mouse mal model, Yoshi et al. , Kidney international, vol 66, 1677-1685, 2004.
  • Kidney international, vol 66, 1677-1685, 2004
  • Patent Document 3 50 mg / kg of ganciclovir is administered.
  • ganciclovir is administered at 5 mg / kg every 12 hours, so in the study of Non-Patent Document 3, it is 10 times the dose of normal renal function (5 mg / kg).
  • ganciclovir is determined to be administered at a dose of 5 mg / kg once every 48 to 96 hours.
  • ganciclovir has side effects such as neutropenia and thrombocytopenia, and thus is restricted in use.
  • TNP-470 is administered at 20 mg / kg, and there is still concern about side effects.
  • Patent Document 1 and Patent Document 2 handling is not simple because it has a predetermined oligonucleotide or glycoprotein as a main component, and in Patent Document 2, migration of endothelial cells to the extracellular skeleton in angiogenesis and Although the production of type I collagen, which is the main component of the extracellular skeleton, can be suppressed when new blood vessels are created by proliferation, the results of suppressing and inhibiting peritoneal thickening are not disclosed.
  • an object of the present invention is to provide a thickening inhibitor that suppresses or prevents peritoneal thickening and suppresses peritoneal thickening that reduces side effects, or a dialysate containing the thickening inhibitor.
  • the present invention has the following chemical formula (1):
  • R 1 , R 2 , R 3 and R 4 represent the same or different hydrogen atom or lower alkyl group
  • R 5 represents a hydrogen atom, lower alkyl group or lower acyl group
  • X represents a sugar residue.
  • n is an integer of 0 to 6
  • m is 1 to 6 Integer
  • the peritoneal thickening inhibitor or the peritoneal thickening inhibitor according to the present invention contains chromanol glycoside as an active ingredient, it has an extremely high water solubility (about 100 g / 100 ml) which is a property of the chromanol glycoside, and
  • the peritoneal thickening inhibitor or the peritoneal thickening inhibitor containing the chromanol glycoside of the present invention can exhibit the characteristics of an amphiphilic molecule exhibiting oil solubility (octanol / water partition coefficient> 3). Unlike conventional drugs that are insoluble or poorly soluble in water, they maintain high lipid affinity even when dissolved in water, so they can permeate cell membranes and enter cells. .
  • the first of the present invention is the following chemical formula (1):
  • R 1 , R 2 , R 3 and R 4 represent the same or different hydrogen atom or lower alkyl group
  • R 5 represents a hydrogen atom, lower alkyl group or lower acyl group
  • X represents a sugar residue.
  • n is an integer of 0 to 6
  • m is 1 to 6
  • Hsp47 is used for procollagen processing in the endoplasmic reticulum, triple chain helix formation, or transport of procollagen from the endoplasmic reticulum to the Golgi apparatus.
  • Increased Hsp47 expression stimulates the accumulation of collagen molecules in the extracellular skeleton, as it is believed to function as a specific molecular chaperone for collagen in the aspect of secretion. Therefore, in the Example mentioned later, the effect of the thickening inhibitor which concerns on this invention is confirmed by measuring the ratio for which the type I collagen occupies with respect to a wall side peritoneum, and Hsp47 positive cell.
  • the type I collagen production and / or Hsp47 positive cells can be suppressed / inhibited by the thickening inhibitor according to the present invention.
  • the lower alkyl group of R 1 , R 2 , R 3 , R 4 and R 5 has 1 to 8 carbon atoms, preferably 1 to 6 carbon atoms.
  • the lower alkyl group is preferably, for example, methyl group, ethyl group, propyl group, isopropyl group, butyl group, isobutyl group, pentyl group, isopentyl group, hexyl group, heptyl group, octyl group and the like. In these, a methyl group or an ethyl group is preferable.
  • the lower acyl group for R 5 may be a lower acyl group having 1 to 8, preferably 1 to 6 carbon atoms, such as a formyl group, acetyl group, propionyl group, butyryl group, isobutyryl group, valeryl group. , Isovaleryl group, pivaloyl group, hexanoyl group, heptanoyl group, octanoyl and the like. In these, an acetyl group, a propionyl group, or a butyryl group is preferable.
  • the monosaccharide residues of X include glucose, galactose, fucose, xylose, mannose, rhamnose, fructose, arabinose, lyxose, ribose, allose, altrose, idose, talose, deoxyribose, 2-deoxyribose, quinose, Examples thereof include sugar residues such as Abequase.
  • Examples of the oligosaccharide residue of X include those in which 2 to 4 monosaccharides are bound, such as maltose, lactose, cellobiose, raffinose, xylobiose, and sucrose sugar residues.
  • the hydrogen atom of the hydroxyl group in the sugar residue of X is a lower alkyl group, preferably a lower alkyl group having 1 to 8 carbon atoms, or a lower acyl group, preferably a lower acyl group having 1 to 10 carbon atoms. May be substituted.
  • n is an integer of 0 to 6, preferably 1 to 4, and m is an integer of 1 to 6, preferably 1 to 3.
  • the chromanol glycoside represented by the chemical formula (1) according to the present invention is not particularly limited as long as it is a compound represented by the chemical formula (1). Specifically, 2-(( ⁇ or ⁇ ) -D -Glucopyranosyl) methyl-2,5,7,8-tetramethylchroman-6-ol; 2-(( ⁇ or ⁇ ) -D-glucopyranosyl) ethyl-2,5,7,8-tetramethylchroman-6- 2-; (( ⁇ or ⁇ ) -D-glucopyranosyl) propyl-2,5,7,8-tetramethylchroman-6-ol; 2-(( ⁇ or ⁇ ) -D-glucopyranosyl) isopropyl-2, 5,7,8-tetramethylchroman-6-ol; 2-(( ⁇ or ⁇ ) -D-glucopyranosyl) butyl-2,5,7,8-tetramethylchroman-6-ol; 2-(( ⁇ Or
  • the chromanol glycoside according to the present invention is not particularly limited and may be synthesized by a known method or purchased commercially.
  • the chromanol glycoside can be obtained by the method described in JP-A-7-118287.
  • the following chemical formula (2) When synthesizing the chromanol glycoside according to the invention, the following chemical formula (2):
  • R 1 , R 2 , R 3 , R 4 , R 5 and n are as defined above
  • 2-substituted alcohols and oligosaccharides, soluble starch, starch or cyclodextrin It is produced by an enzymatic reaction comprising reacting in the presence of an enzyme that catalyzes the sugar rearrangement action and binding a specific hydroxyl group of the sugar specifically to the hydroxyl group at the 2-position of the 2-substituted alcohol (enzymatic method). ).
  • the 2-substituted alcohol represented by the chemical formula (2) used as a raw material in the above reaction is a known substance, such as JP-B-1-43755 and JP-B 1-49135 and the like.
  • R 1 , R 2 , R 3 and R 4 are methyl groups
  • R 5 is a hydrogen atom
  • n is a 2-substituted alcohol in which n is 1, Trolox is It can be easily obtained by heating under reflux in diethyl ether in the presence of lithium aluminum hydride.
  • ⁇ -glucosidase (EC 3.2.1. EC) is used for malto-oligosaccharides from maltose to maltotetraose. It is desirable to act 20).
  • ⁇ -glucosidase those derived from almost all sources can be used. Specifically, ⁇ -glucosidase derived from Saccharomyces sp.
  • cyclodextrin glucanotransferase derived from Bacillus macerans manufactured by Amano Pharmaceutical Co., Ltd.
  • cyclodextrin derived from Bacillus stearothermophilus manufactured by Hayashibara Biochemical Research Institute Co., Ltd.
  • examples of the glucanotransferase include cyclodextrin glucanotransferase derived from Bacillus megaterium, Bacillus circulans ATCC 9995 (Bacillus circulans ATCC 9995), and the like.
  • the reaction conditions in the above reaction vary depending on the type of chromanol glycoside and enzyme used.
  • an organic solvent such as dimethyl sulfoxide, N, N-dimethylformamide, methanol, ethanol, acetone, and acetonitrile.
  • dimethyl sulfoxide And N, N-dimethylformamide is preferably used.
  • the addition concentration of the organic solvent is 1 to 50 (v / v)%, and considering the reaction efficiency, it is preferably 5 to 35 (v / v)%.
  • the concentration of 2-substituted alcohol is preferably saturated or close to the concentration in the reaction solution.
  • the type of sugar to be used is preferably a low molecular weight molecule from maltose to maltotetraose, preferably maltose.
  • the sugar concentration is 1 to 70 (w / v)%, preferably 30 to 60 (w / v)%.
  • the pH is 4.5 to 7.5, preferably 5.0 to 6.5.
  • the reaction temperature is 10 to 70 ° C, preferably 30 to 60 ° C.
  • the reaction time is 1 to 40 hours, preferably 2 to 24 hours. However, it goes without saying that these conditions are affected by the amount of enzyme used.
  • the target chromanol glycoside is obtained with high purity by treating the reaction solution with column chromatography using XAD (organo Corporation) as a carrier.
  • a reaction condition when a chromanol glycoside having m of 1 in chemical formula (1) is synthesized using cyclodextrin glucanotransferase it is desirable to dissolve a 2-substituted alcohol in a sugar solution.
  • an organic solvent is desirable, and examples thereof include dimethyl sulfoxide, N, N-dimethylformamide, methanol, ethanol, acetone, and acetonitrile.
  • the concentration of the organic solvent to be added is 1 to 50 (v / v)%, preferably 5 to 35 (v / v)% in view of reaction efficiency.
  • the concentration of the 2-substituted alcohol is preferably set to a saturated concentration or a high concentration close thereto in the reaction solution.
  • sugars used in the above reaction include maltooligosaccharides having a degree of polymerization of maltotriose or higher, soluble starch, starch, and cyclodextrins ( ⁇ , ⁇ , ⁇ ).
  • the sugar concentration is 1 to 70 (w / v)%, preferably 5 to 50 (w / v)%.
  • the pH is 4.5 to 8.5, preferably 5.0 to 7.5.
  • the reaction temperature is 10 to 70 ° C, preferably 30 to 60 ° C.
  • the reaction time is 1 to 60 hours, preferably 2 to 50 hours. However, these conditions are affected by the amount of enzyme used.
  • the chromanol glycoside obtained by such a reaction is a mixture having 1 to 8 positions of m.
  • glucoamylase EC 3.2.1.3
  • the reaction temperature at this time is 20 to 70 ° C., preferably 30 to 60 ° C.
  • the reaction time is 0.1 to 40 hours, preferably 1 to 24 hours.
  • these conditions are affected by the amount of enzyme used.
  • the chromanol glycoside having m of 1 in chemical formula (1) has a high purity. can get.
  • a mixture having 1 to 8 positions in the chemical formula (1) obtained by cyclodextrin glucanotransferase under the same conditions as described above By reacting ⁇ -amylase (EC 3.2.1.2) with a chromanol glycoside having the following form, only a chromanol glycoside having 1 or 2 in chemical formula (1) is obtained.
  • the reaction temperature at this time is 20 to 70 ° C., preferably 30 to 60 ° C., and the reaction time is 0.1 to 40 hours, preferably 1 to 24 hours. However, these conditions are affected by the amount of enzyme used.
  • the liquid after ⁇ -amylase treatment is obtained by high-purity chromanol glycosides in which m in formula (1) is 2 by column chromatography using XAD (organo Corporation) as a carrier.
  • XAD organo Corporation
  • a mixture having 1 to 8 positions in m in chemical formula (1) obtained by cyclodextrin glucanotransferase under the same conditions as described above A high-purity chromanol glycoside can be obtained for each m by treating the chromanol glycoside having the following form with a preparative chromatography using HPLC or the like.
  • the chromanol glycoside used in the present invention is obtained by protecting the hydroxyl group at the 6-position of the 2-substituted alcohol with a protecting group by the method described in JP-A-11-279192 (hereinafter referred to as “sugar receptor”). And a sugar derivative (hereinafter referred to as “sugar donor”) in which a leaving group is introduced at the anomeric position and other hydroxyl groups are protected by a protecting group (organic synthesis method).
  • Examples of the protecting group for protecting the hydroxyl group at the 6-position of the sugar acceptor used in the above reaction include acetyl group, benzoyl group, bivaloyl group, chloroacetyl group, levulinoyl group, benzyl group, p-methoxybenzyl group, allyl group, Examples thereof include a t-butyldimethylsilyl group, a t-butyldiphenylsilyl group, a trimethylsilyl group, and a trityl group, and an acetyl group and a benzoyl group are particularly preferable.
  • the leaving group introduced into the anomeric position of the sugar donor used in the above reaction includes halogen atoms such as chlorine, bromine and fluorine, sulfur compounds such as thiomethyl group, thioethyl group and thiophenyl group, and trichloroacetimide group
  • halogen atoms such as chlorine, bromine and fluorine
  • sulfur compounds such as thiomethyl group, thioethyl group and thiophenyl group
  • trichloroacetimide group are preferable.
  • Examples of the protecting group for protecting hydroxyl groups other than the anomeric position include acyl protecting groups such as acetyl group, benzoyl group, pivaloyl group, chloroacetyl group and levulinoyl group, and benzyl group, p-methoxybenzyl group, allyl group, Examples include ether-type protecting groups such as t-butyldimethylsilyl group, t-butyldiphenylsilyl group, trimethylsilyl group, and trityl group. Among them, acyl-type protecting groups, particularly acetyl groups are preferred.
  • sugar donors can be easily prepared by introducing a protecting group into all hydroxyl groups of the sugar by a well-known method and then substituting the anomeric position with a leaving group.
  • the sugar acceptor and the sugar donor are dissolved in a nonpolar solvent.
  • the amount of sugar acceptor and sugar donor charged is such that the molar ratio of sugar donor to sugar acceptor is 1.0 to 1.5, preferably 1.1 to 1.3.
  • the nonpolar solvent include methylene chloride and benzene.
  • Activating agents include trifluoroboric acid / ether complex, silver perchlorate, silver trifluoromethanesulfonate, mercury bromide, mercury cyanide, N-iodosuccinimide-trifluoromethanesulfonic acid, dimethylmethylthiosulfonium triflate, Examples thereof include p-toluenesulfonic acid.
  • a heavy metal salt such as silver perchlorate.
  • the reaction temperature is 5 to 30 ° C., preferably 10 to 25 ° C., and the reaction time is 12 to 48 hours, preferably 20 to 30 hours.
  • reaction product is purified by silica gel column chromatography or the like, and the protecting group is deprotected with sodium hydroxide, methanolic hydrochloric acid or the like to give 2- ( ⁇ -L-fucopyranosyl) methyl-2,5,7. , 8-Tetramethylchroman-6-ol, 2- ( ⁇ -L-rhamnopyranosyl) methyl-2,5,7,8-tetramethylchroman-6-ol, 2- ( ⁇ -D-xylopyranosyl) methyl-2 5,7,8-tetramethylchroman-6-ol, etc. (Japanese Patent Laid-Open No. 11-279192).
  • the chromanol glycoside obtained in this way is generally highly water-soluble and rich in oil-solubility, so it is localized in the vicinity of the cell membrane, penetrates the cell membrane, and further enters the cell. Can also enter.
  • the peritoneal thickening inhibitor according to the present invention may contain only the chromanol glycoside represented by the above chemical formula (1) as an active ingredient, or may contain other components.
  • Additives such as pharmaceutically acceptable carriers, buffering agents, preservatives, antioxidants, flavoring agents, coloring agents, and sweetening agents used in the pharmaceutical field can also be used as appropriate.
  • the pharmaceutically acceptable carrier include excipients such as lactose, dextrin, sucrose, mannitol, corn starch, and sorbitol, and adjuvants such as crystalline cellulose and polyvinylpyrrolidone, which are used alone or in appropriate combination. be able to.
  • the content of these excipients, adjuvants, or additives can be appropriately determined by those skilled in the art.
  • this formulation may contain the other medicinal component which does not inhibit the peritoneum thickening suppression effect.
  • the peritoneal thickening inhibitor of the present invention can be used as various pharmaceutical compositions in which a physiologically harmless solid or liquid pharmaceutical carrier is blended with a compound represented by the chemical formula (1) which is an active ingredient.
  • This pharmaceutical composition is prepared and used in various preparation forms according to the administration method. Examples of the dosage form include tablets, granules, pills, capsules, solutions, syrups, suspensions, emulsions, and injections.
  • a pharmaceutical carrier commonly used excipients, binders, disintegrants, lubricants, coating agents, solubilizers, emulsifiers, suspending agents, stabilizers or solvents can be used.
  • the compound represented by the chemical formula (1) according to the present invention and the pharmaceutical composition described above are administered by oral administration, parenteral administration such as intravenous injection, sustained release administration by a sustained release formulation, local administration catheter or the like. Can be used by topical administration.
  • the actual dose of the compound represented by the chemical formula (1) according to the present invention depends on the age of the patient, the severity of the symptoms, the route of administration, and the like. On the other hand, it is, for example, 10 to 1000 mg, preferably 20 to 600 mg. Such doses are preferably administered to patients in need of treatment in 1 to 5 divided doses per day.
  • the peritoneal dialysis solution for suppressing peritoneal thickening according to the present invention preferably contains a chromanol glycoside represented by the above chemical formula (1) and an osmotic pressure regulator.
  • peritoneal hyperplasia One of the causes of peritoneal hyperplasia currently is that mesothelial cells on the peritoneal surface are exposed to external stimuli such as acidic dialysate and end-sugar products of sugars such as glucose, and produce substances that form the extracellular skeleton such as collagen. As a result, it is considered that fibroblasts and the like grow and the collagen layer of the peritoneum becomes thick.
  • the cause of peritoneal thickening has not yet been elucidated, and as shown in the following examples, peritoneal thickening is suppressed by adding the chromanol glycoside according to the present invention to the dialysate.
  • the peritoneal dialysis solution according to the present invention preferably contains the chromanol glycoside represented by the above chemical formula (1) at a concentration of 0.001 to 0.3 g / l, preferably 0.002 to 0.2 g / l. More preferably, it is contained at a concentration of 0.005 to 0.15 g / l. If the concentration of the chromanol glycoside is less than 0.001 g / l, the effect cannot be expected. If it exceeds 0.3 g / l, an effect corresponding to the concentration cannot be expected.
  • the osmotic pressure regulating substance according to the present invention is not particularly limited as long as it is an osmotic pressure regulating substance that is safe for a living body, and examples thereof include saccharides, peptides, amino acids, and the like.
  • the saccharide include monosaccharides such as glucose, galactose, mannose and fructose, disaccharides such as sucrose, maltose, lactose and trehalose, glycogen, malto-oligosaccharides, isomalt-oligosaccharides, oligoglycosyl sucrose, fructooligosaccharides and galacto-oligosaccharides.
  • Examples include sugars, sugar alcohols such as maltitol, erythritol, and xylitol, and derivatives thereof. Of these, glucose and glucose derivatives are preferred.
  • the glucose derivative may be a chemically modified glucose or a polysaccharide having glucose as a basic unit. Even more preferred is D-glucose.
  • a dialysate containing an amino acid instead of glucose or together with glucose as an osmotic pressure regulating substance according to the present invention may also be mentioned.
  • methionine is 48 mg or less per 100 mL of total solution
  • phenylalanine / tyrosine ratio is about 1.3 to about 3.0
  • a dialysate containing an amino acid mixture at a concentration of 1.6 w / v% or less can also be used.
  • the peritoneal dialysate according to the present invention preferably contains the osmotic pressure regulating substance at a concentration of 2 to 35 g / l, more preferably 5 to 30 g / l, and a concentration of 10 to 25 g / l. It is further preferable to contain.
  • the osmotic pressure of the peritoneal dialysate according to the present invention is preferably 300 to 500 mOsm / kg, more preferably 330 to 490 mOsm / kg.
  • the osmotic pressure regulating substance and the osmotic pressure are preferably used within the above range depending on an excessive amount of body fluid of the patient.
  • the peritoneal dialysis solution according to the present invention may further contain other components as necessary, and can contain, for example, an electrolyte (sodium ion, calcium ion, magnesium ion, chloro ion, etc.).
  • an electrolyte sodium ion, calcium ion, magnesium ion, chloro ion, etc.
  • the electrolyte is added to the peritoneal dialysis solution, it is preferably added so as to fall within the range of the following composition examples.
  • the peritoneal dialysate according to the present invention may be either an acidic dialysate or a neutral dialysate, and the pH of the peritoneal dialysate according to the present invention is preferably 4 to 8, and more preferably 4.5 to 7.5.
  • an alkalizing agent such as lactate ion or bicarbonate ion may be included.
  • an organic acid or the like can be contained depending on the concentration difference between the total cation and the chloro ion.
  • organic acids examples include propionic acid, malic acid, fumaric acid, succinic acid, oxalacetic acid, N-acetylglycine, N-acetyl-L-cysteine, glutaric acid, glucuronic acid, ascorbic acid, citric acid, isocitrate Acid, gluconic acid, N-acetyl-L-aspartic acid, N-acetyl-L-glutamic acid, N-acetyl-L-methionine, N-acetyl-L-proline, N-acetyl-L-valine, N-acetyl- Examples include L-glutamine, N-acetyl-L-arginine, N-acetyl-L-histidine, N-acetyl-L-leucine, N-acetyl-L-tryptophan, and salts thereof.
  • the alkalinizing agent or organic acid is added to the peritoneal dialysis solution, it is
  • the method for preparing the peritoneal dialysis fluid according to the present invention is not particularly limited.
  • sodium ion, calcium chloride, magnesium chloride, sodium lactate, calcium salt, magnesium salt, sodium bicarbonate and other cations and chloro ion sources, acid components, etc. can be prepared in the same manner as a general peritoneal dialysis solution that dissolves in water.
  • it is desirable that the peritoneal dialysis solution prepared by dissolving each solute is sealed in a soft plastic bag or glass container and then subjected to high-pressure steam sterilization or hot water sterilization.
  • composition example of peritoneal dialysate according to the present invention (when the solvent is water): Sodium ion (Na + ): 130 to 135 mEq / L, Calcium ion (Ca 2+ ): 2-4 mEq / L, Magnesium ion (Mg 2+ ): 0.4 to 0.6 mEq / L, Chlor ion (Cl ⁇ ): 94 to 97 mEq / L, Glucose: 12-40 g / l, chromanol: 0.01-0.1 g / l and alkalizing agent containing lactate ions: 35-45 mEq / L.
  • the present invention will be described using the following examples and comparative examples. However, the technical scope of the present invention is not limited to the following examples.
  • the measurement of tissue length, the measurement of% Area, and the number of cells are counted using image analysis software Image J (reference: Yochisha Image Analysis Text NIH Image, Scion Image, Image J Practical Course Revision 3rd edition).
  • mice C57 / BL6, male, 7 weeks old, weight 21 ⁇ 1 g
  • Junor BJR Briggs JD, Forwell MA, Dobbie JW, Henderson I: (Sclerosing peritonitis-The tribulation of chlorhexidine in alcohol. Perit Dial Bull 101-104, 1985).
  • the mice were divided into a CG group (5 mice), a control group (4 mice), and a TMG group (5 mice), and the following operations were performed on each group.
  • mice 0.2 ml of 0.1% chlorhexidine / 15% ethanol / saline solution was administered intraperitoneally three times a week.
  • Control group 0.2 ml of a 15% ethanol / saline solution was administered intraperitoneally three times a week.
  • TMG is an abbreviation for 2- ( ⁇ -D-glucopyranosyl) methyl-2,5,7,8-tetramethylchroman-6-ol and is represented by the following chemical formula (3).
  • peritoneal tissue section ⁇ Preparation of peritoneal tissue section> After the mice were anesthetized with ether, the blood was killed and the peritoneum was collected from the left flank. The peritoneum was collected at the same location in each mouse. Next, the obtained peritoneum was fixed with 10% formalin / 0.1 M phosphate buffer (pH 7.2) and then embedded in paraffin to prepare a tissue section having a thickness of 2 to 3 ⁇ m. These sections were made perpendicular to the peritoneum so that the thickness of the peritoneum could be measured. "Example 2" ⁇ Effect on peritoneal thickening> The peritoneal tissue section prepared in Example 1 The results of E staining are shown in FIGS. 1-A, 1-B, and 1-C. In addition, the thickness of the peritoneum was measured. Ten animals were measured at random and the average value was determined. The results are shown in Table 1 below.
  • Example 3 ⁇ Effects on type I collagen>
  • the results of immunostaining the peritoneal tissue section prepared in Example 1 with the polyclonal antibody RABBIT ANTI MOUSE COLLAGE I (polyclonal IgG) (AbD serotec; UK) against type I collagen are shown in FIG. 2-A, FIG. 2-B, and FIG. Shown in 2-C.
  • Antibody activation was performed in an autoclave, and the antibody diluted 250 times was used for immunostaining.
  • the proportion of type I collagen to the wall-side peritoneum was randomly measured at 10 locations per animal, and the average value was calculated. The results are shown in Table 2 below.
  • Example 4 ⁇ Inhibitory effect of Hsp47 positive cells>
  • the results of immunostaining the peritoneal tissue section prepared in Example 1 with a polyclonal antibody Hsp47 Polyantibody Antibody (BIOVISION: USA) against Heat shock protein 47 (Hsp) are shown in FIGS. 3-A, 3-B, and 3-C. Show. Antibody activation was performed in an autoclave, and the antibody diluted 20 times was used for immunostaining. In a 400 ⁇ field, 10 Hsp47 positive cells were randomly measured per mouse, and the average value was calculated. The results are shown in Table 3 below.

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Abstract

L'invention porte sur un agent d'inhibition de l'épaississement pour inhiber l'épaississement de la membrane péritonéale, par lequel l'épaississement de la membrane péritonéale peut être inhibé, empêché ou traité avec des effets secondaires diminués ; et sur une solution de dialyse qui contient cet agent d'inhibition de l'épaississement. De manière spécifique, l'invention porte sur un agent pour inhiber l'épaississement de la membrane péritonéale qui contient, en tant que principe actif, un chromanol glycoside représenté par la formule chimique (1) ; et sur une solution de dialyse le contenant. Dans la formule chimique (1), R1, R2, R3 et R4 sont soit identiques soit différents et représentent chacun un atome d'hydrogène ou un groupe alkyle inférieur ; R5 représente un atome d'hydrogène, un groupe alkyle inférieur ou un groupe acyle inférieur ; X représente un reste monosaccharide ou un reste oligosaccharide dans lequel l'atome d'hydrogène, dans un groupe hydroxyle dans chaque reste saccharide, peut être substitué par un groupe alkyle inférieur ou un groupe acyle inférieur ; n est un entier de 0 à 6 ; et m est un entier de 1 à 6.
PCT/JP2010/055728 2009-03-31 2010-03-30 Agent pour inhiber l'épaississement de la membrane péritonéale WO2010113960A1 (fr)

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JP2011507223A JP5652963B2 (ja) 2009-03-31 2010-03-30 腹膜肥厚抑制剤
CN201080019637.5A CN102596982B (zh) 2009-03-31 2010-03-30 腹膜肥厚抑制剂
US13/259,558 US8841262B2 (en) 2009-03-31 2010-03-30 Agent for inhibiting peritoneal membrane thickening
EP10758731.3A EP2415775B1 (fr) 2009-03-31 2010-03-30 Agent pour inhiber l'épaississement de la membrane péritonéale

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Citations (2)

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Publication number Priority date Publication date Assignee Title
EP0611152A1 (fr) * 1993-02-10 1994-08-17 Cci Corporation Nouvel chromanol glycoside et leur procédé de préparation
EP0965344A1 (fr) * 1996-12-10 1999-12-22 Cci Corporation Agent prophylactique et therapeutique pour les maladies intestinales inflammatoires

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EP0555087B1 (fr) * 1992-02-04 1998-08-05 Baxter International Inc. Solutions pour dialyse péritonéale contenant au moins un dipeptide
AU689036B2 (en) 1995-05-10 1998-03-19 Kureha Chemical Industry Co., Ltd. Pharmaceutical composition containing substance inhibiting HSP47 production
JP2892300B2 (ja) 1995-05-10 1999-05-17 呉羽化学工業株式会社 Ｈｓｐ４７合成抑制剤
KR100390630B1 (ko) * 1999-07-02 2003-07-07 이희발 항 산화제를 함유한 복막투석액
JP2001031588A (ja) 1999-07-21 2001-02-06 Terumo Corp 腹膜肥厚抑制剤
JP2001181191A (ja) 1999-12-24 2001-07-03 Cci Corp 慢性関節リウマチ疾患予防および治療剤

Patent Citations (2)

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Publication number Priority date Publication date Assignee Title
EP0611152A1 (fr) * 1993-02-10 1994-08-17 Cci Corporation Nouvel chromanol glycoside et leur procédé de préparation
EP0965344A1 (fr) * 1996-12-10 1999-12-22 Cci Corporation Agent prophylactique et therapeutique pour les maladies intestinales inflammatoires

Non-Patent Citations (3)

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Title
BOZKURT, D. ET AL.: "Can N-acetylcysteine preserve peritoneal function and morphology in encapsulating peritoneal sclerosis?", PERITONEAL DIALYSIS INTERNATIONAL, vol. 29, no. SUP.2, February 2009 (2009-02-01), pages S202 - S205, XP008165632 *
LEE, H.B. ET AL.: "Mechanisms of epithelial- mesenchymal transition of peritoneal mesothelial cells during peritoneal dialysis", JOURNAL OF KOREAN MEDICAL SCIENCE, vol. 22, no. 6, 2007, pages 943 - 945, XP008162014 *
NOH, H. ET AL.: "Oxidative stress during peritoneal dialysis: Implications in functional and structural changes in the membrane", KIDNEY INTERNATIONAL, vol. 69, no. 11, 2006, pages 2022 - 2028, XP008162013 *

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US20120083461A1 (en) 2012-04-05
JP5652963B2 (ja) 2015-01-14
EP2415775A1 (fr) 2012-02-08
CN102596982B (zh) 2015-03-18
JPWO2010113960A1 (ja) 2012-10-11
CN102596982A (zh) 2012-07-18
EP2415775B1 (fr) 2017-08-23
EP2415775A4 (fr) 2012-10-17

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